Background Advances in intensive care medicine have increased the use of life-sustaining treatments for critically ill patients, resulting in a growing number of end-stage patients receiving end-of-life care in the intensive care unit (ICU). Because many patients lack decision-making capacity, family members are often required to participate in complex end-of-life decision-making under conditions of emotional stress and uncertainty. Understanding family members’ experiences and needs is essential for improving clinical decision support in ICU settings. Methods A qualitative study was conducted using semi-structured interviews with 10 family members of end-stage ICU patients who experienced difficulties in end-of-life decision-making. Participants were recruited using purposive sampling. Interview data were audio-recorded, transcribed verbatim, and analyzed usingColaizzi’s seven-step method. Results 4 themes and 12 sub-themes were identified: (1) decision-making experiences (hesitation, emotional pain and distress, acceptance of reality); (2) decision-making status (decision-making dilemmas, conflict between quality and length of life, and challenges in understanding and communicating the patient’s condition); (3) influencing factors (patient-related, family-related, sociocultural and medical factors); (4) decision-making needs (information needs and decision support needs). Family members reported substantial emotional distress and uncertainty throughout the decision-making process. Conclusions Family members of end-stage ICU patients experience complex psychological and informational challenges during end-of-life decision-making. Limited decision-making capacity, insufficient information, and multiple contextual influences hinder effective participation in decision-making. Providing timely, structured communication and psychological support is essential to improve the quality of end-of-life decision-making in ICU settings. Trial registration Not applicable.

INTRODUCTION:Workplace violence against health care workers is a widespread global issue, particularly in emergency departments. This study aimed to identify and visualize research on workplace violence in the emergency department and reveal global trends in this field. METHODS:Publications related to workplace violence in the emergency department were retrieved from the Web of Science Core Collection database. VOSviewer, CiteSpace, and Scimago Graphica were used for bibliometric analysis and visualization. RESULTS:A total of 348 articles were selected for this study. These articles were published across 50 countries from November 1, 1988 to December 31, 2024, with the United States, Australia, and China leading in publication output. These articles were featured in 142 journals, with the Journal of Emergency Nursing publishing the most (n = 33). Gillespie is both the most prolific author and among the most frequently cited in this field. Keyword clustering analysis identified 4 distinct research themes, including factors associated with the occurrence of violence, prevention strategies for workplace violence, its psychological and occupational impacts on emergency department staff, and different forms of violence. In addition, keyword burst analysis revealed emerging trend topics, notably "COVID-19," "experience," and "qualitative research." DISCUSSION:Despite a growing body of research on workplace violence in the emergency department in recent years, incidents of violence continue to arise. This bibliometric study is the first to comprehensively summarize the research developments and trends in this field, identifying research frontiers and hotspots. The findings offer new perspectives on workplace violence in the emergency department and may inform future research on violence prevention strategies.

PURPOSE:This study aims to evaluate the effect of acupoint application on the prevention of postoperative sore throat (POST), cough, expectoration, hoarseness, and patient satisfaction after general anesthesia. DESIGN:Randomized controlled trial. METHODS:A randomized double-blind clinical trial was designed. In total, 112 participants scheduled for gynecology or general surgery under general anesthesia were randomly assigned to 1 of 2 groups. One was the acupoint application group (group A) that received a session of acupoint application over the acupoints of Tiantu (RN22), Neiguan (PC6, bilateral), Zusanli (ST36, bilateral), and Yongquan (KI1, bilateral). The other was the placebo group (group P) and received a session of sham acupoint application in the same acupoints. In virtue of the visual analog scale score, the effects of acupoint application were measured by the incidence of POST, cough, expectoration, and hoarseness before, 24 hours, and 48 hours after the intervention, and patient satisfaction after surgery. FINDINGS:The incidence of POST was lower in group A versus group P at 24 hours [13 (24.5%) vs 23 (44.2%), P = .033] and at 48 hours [3 (5.7%) vs 15 (28.8%), P = .002]. Compared with group P, the visual analog scale of POST was dramatically lower in group A at 24 and 48 hours (P = .024; P < .001). Group A had a reduced incidence of cough, expectoration, and hoarseness than group P at 48 hours. In addition, patients in group A felt more satisfied postoperatively than patients in group P (96.2% vs 80.8%, P = .013). CONCLUSIONS:Acupoint application effectively relieved POST in adults following general endotracheal anesthesia, reduced the incidence of postoperative cough, expectoration, and hoarseness, as well as improved patient satisfaction.

Cardiogenic shock (CS) is a life-threatening syndrome characterized by peripheral hypoperfusion and organ dysfunction caused by primary heart disease. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a temporary mechanical circulatory support device for CS, used in cases of profound shock, biventricular failure, respiratory failure, and cardiac arrest that require urgent maximal support. While VA-ECMO provides effective tissue perfusion and ensures oxygen supply to organs, it is also associated with severe complications, among which acute kidney injury (AKI) is one of the most common and serious. To date, no comprehensive review has been conducted on the pathophysiology, influencing factors, and treatment of AKI associated with VA-ECMO. This paper aims to elaborate on the pathophysiological mechanisms, influencing factors, and treatment options for AKI in patients with CS undergoing VA-ECMO, providing clinical and nursing references.

Aims and ObjectivesTo investigate knowledge, attitudes, and practices regarding the application of the Injury Severity Score (ISS) among emergency department nurses in China and the factors influencing these variables.BackgroundISS is the first trauma scoring method to be developed and the most widely used in clinical practice. The correct application of the ISS by emergency department nurses plays an important role in assisting in the diagnosis and treatment of trauma patients, and it is crucial to understand nurses' knowledge, attitudes and practices.DesignA cross-sectional multicentre study.MethodsNurses from the emergency departments of 25 grade II and grade III hospitals in Gansu Province, China participated in this study. Data was collected online using a self-administered questionnaire. Student's t-test or analysis of variance was performed to compare the differences between the groups. Multiple logistic regression analysis identified factors influencing nurses' knowledge, attitudes and practices regarding applying ISS. A STROBE checklist was used to report findings.ResultsAmong 459 nurses, a good level of attitude and passing levels of knowledge and practice regarding applying the ISS were revealed. Nurses in higher hospital grades, who had been exposed to ISS and received training had higher levels of knowledge and practices. Previous exposure to the ISS and training related to it were factors that influenced nurses' attitudes.ConclusionsChinese emergency department nurses' knowledge, attitudes and practices of applying the ISS still need to be improved. Hospitals and nursing managers should provide training opportunities for nurses about ISS knowledge and practices, while grade II hospitals should pay more attention to training and continuing education in this area.Relevance to Clinical PracticeIn hospitals, nursing managers may benefit from enhancing related education and training to promote the emergency department nurses' knowledge and practice of the ISS, by developing specific curricula and providing continuing education and training opportunities, while grade II hospitals should pay more attention to training and continuing education in this area.No patient or Public ContributionsThis study focused on emergency department nurses' knowledge, attitudes, and practices regarding the application of the ISS. The research questions and design were derived from clinical nursing practice, literature review, and expert panel review, and patients or the public are temporarily not involved.

This study aimed to examine the effect of implementing Enhanced Recovery After Surgery (ERAS) measures during the perioperative period of laparoscopic radical gastric cancer on patient recovery post-surgery.

Background: Health education is an important part of nursing care. Verbal health education is a common practice in surgical wards, which is often time-consuming and laborious. This study aimed to ascertain whether multimedia health education can reduce nurses' workload without affecting the satisfaction of surgical patients and companions.Methods: We conducted a parallel-group, prospective randomized controlled trial at Lanzhou University’s First Hospital’s Hepatobiliary Surgery Institute between July 2019 and May 2022. Eligible patients (≥18 years) with general surgical conditions and acceptable for surgery were randomly assigned (1:1) to receive a multi-media health education group or a standard health education group. Randomization was performed by an independent statistician using a computer-generated randomization list. The nurses' workload and satisfaction (among nurses, patients, family members, and doctors) were the main outcomes; the anxiety level of patients and the variables affecting nurse workload were the secondary outcomes. This study is now complete and was submitted to ClinicalTrials.gov with the number NCT03989401.Findings: A total of 184 eligible participants were randomly assigned to receive multimedia health education and standard health education. The results showed that the duration of health education of nurses in the intervention group was significantly shorter [1·61 (2·41)]than it was in the control group [16·94 (3·96)]. Multimedia health education had no impact on the satisfaction of nurses [73·46 (2·36) vs. 67·16 (5·52)], patients [53·35 (2·09) vs. 47·86 (5·00)], their families [53·35 (2·28) vs. 47·86 (4·56)] and doctors [73·33 (2.41) vs. 68·07 (4·92)] with health education (P﹤0·001), nor did it have any impact on the anxiety levels and complications of patients (P> 0·05).Interpretation: Workload on nurses can be reduced by using multi-media health education without compromising patient satisfaction.Trial Registration Details: This study is now complete and was submitted to ClinicalTrials.gov with the number NCT03989401.Funding Information: This work was supported by Gansu Province natural sciences fundation (21JR7RA368) and the Foundation of The First Hospital of Lanzhou University (ldyyyn-2019-15).Declaration of Interests: The authors have declared no conflict of interests related to the study.Ethics Approval Statement: The First Hospital of Lanzhou University's ethics committee approved the research protocol (registry number: LDYYLL2019-203). Written informed consent was given by each patient or their legal representative.

Background: Enhanced recovery after surgery (ERAS) is a standard procedure for perioperative patient management. By taking patients as the center, evidence-based medical evidence as the basis, social and scientific development situation as the orientation, humanistic construction and lean management as the entry point, and personnel training and discipline construction as the cornerstone, Enhanced recovery after diseases (ERAD) can further improve the medical outcomes of patients and reduce medical costs. The aim of this study was to investigate the effect of a patient-centered, organ- and disease-centered ERAD diagnosis and treatment model in patients with internal illness.

Background: Enhanced recovery after surgery (ERAS) programs have been applied into hepato-pancreato-biliary (HPB) or gastric surgery many years. Early mobilizations is a key factor for ERAS success. However, implementation of perioperative mobilization programs requires the treatment dose and standard of early mobilization in patients after surgery. Therefore, the present study aims to prospectively evaluate early mobilization after major abdominal surgery, in order to better guide ERAS clinical practice.

目的 了解国内目标体温管理(TTM)的发展现状和变化规律,分析该领域研究热点及未来趋势.方法 以为主题,检索中国知网和万方数据库自建库以来至2022年7月1日的核心期刊论文,借助CiteSpace和Note-Express 软件,采用共词聚类分析法对其进行共现分析和聚类分析.结果 共检索到文献3 548篇,提取高频关键词25个,形成有意义的4个聚类:TTM的内涵与外延、TTM的适用情境、TTM的临床分析、TTM的临床实践.结论 通过分析把握了 TTM的主流方向和焦点问题,临床可结合国内TTM发展现状并制定针对性的干预措施,以期提升护理人员的TTM水平.

Objective:To understand the current situation of knowledge, attitude and practice about target temperature management (TTM) in patients with severe traumatic brain injury (STBI) among intensive care unit ICU nurses and analyze the influencing factors, so as to provide a reference for conducting ICU nurses′ TTM training for patients with STBI.Methods:Applying the method of cross-sectional study, from November to December 2022, a stratified whole-group sampling method was used, stratified by first-, second-, and third-level hospitals, and a self-designed questionnaire on the current status of ICU nurses′TTM for patients with STBI was used to investigate the current status of knowledge, attitude, and practice of neurosurgical ICU, emergency ICU, and comprehensive ICU nurses in 22 second- and third-level hospitals in 11 cities in Gansu Province, and multiple linear regression analysis was used to analyze the factors influencing ICU nurses′ knowledge, attitude, and practice scores.Results:A total of 543 valid questionnaires were returned, and the scores of ICU nurses on the TTM total score, knowledge, attitude and practice dimensions of STBI patients were (76.75 ± 10.42), (7.38 ± 2.74), (39.57 ± 4.87), (29.80 ± 7.18) points respectively. The results of multiple linear regression analysis showed that the factor influencing ICU nurses′ scores on the TTM knowledge dimension for STBI patients was having attended TTM-related training ( t = 2.16, P<0.05); the factors influencing ICU nurses′ scores on the TTM attitude dimension for STBI patients were college, bachelor′s degree and the position of nurse practitioner ( t = 2.65, 2.91, 2.14, all P<0.05); and the factors influencing ICU nurses′ scores on the TTM practice dimension for STBI patients were the age group of 36 to 45 years old, the department having TTM-related criteria and having knowledge of TTM-related guidelines ( t = -2.46, 2.64, 3.85, all P<0.05). Conclusions:ICU nurses have a more positive attitude toward TTM in patients with STBI, but the level of knowledge and practice needs to be improved. Managers should conduct relevant training according to the current situation and influencing factors to improve ICU nurses′ knowledge and practice of TTM in patients with STBI, ensuring the effectiveness and safety of TTM.

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.

目的 总结 8 例儿童曼陀罗群体中毒后的急救与护理经验.方法 2022年 9月我院PICU收治 8例曼陀罗中毒患儿,及时采取鼻胃管洗胃、静脉补充电解质、针对性予以毛果芸香碱皮下注射、及早行血液灌流等综合治疗和专科护理.结果 经多学科协作诊疗和精心护理,2 例阿托品中毒症状严重的患儿以毛果芸香碱皮下注射,7例意识障碍程度较重的患儿行血液灌流治疗,8 例患儿分别于入院治疗后第 3 天、第 5 天康复出院.结论 掌握急性曼陀罗中毒患儿的临床特点,准确评估曼陀罗患儿中毒的程度,迅速采取正确的治疗措施和精心的护理,以提高中毒患儿救治成功率.

Background: "Smart ward" is the intelligent transformation of patient's medical environment and medical services by using Internet, artificial intelligence, Internet of Things technology and intelligent hardware devices, and the construction of smart ward has already started a wave of exploration, aiming to achieve quality medical services with the times. This study aims to create and improve a diversified smart ward based on 5G and explore its effect on accelerating the recovery of lung cancer patients, so as to establish a high-quality, convenient and comprehensive intelligent service system that is "patient-centered" and realize the characteristic exemplary management.

BACKGROUND:Emergency department healthcare professionals have the most contact with patients in cardiac arrest, and their physical and mental state has a significant impact on the quality of cardiopulmonary resuscitation and patient outcomes. However, there is limited research discussing the experience of resuscitation by emergency department healthcare professionals.AIM:To explore the experiences of emergency department healthcare professionals in performing cardiopulmonary resuscitation.METHODS:A descriptive phenomenological study. The study used purposive sampling and selected 9 nurses and 6 physicians from the emergency departments of four general hospitals of different levels in western China between May 2022 and October 2022. Semi-structured interview guides and face-to-face interviews were used to collect information. Colaizzi analysis was used to analyze the data.RESULTS:The study identified 3 themes and 11 sub-themes. These themes and sub-themes include 1) emotional experience (A sense of achievement, A sense of powerlessness and trauma, Stress, Empathy, Psychological resilience strengthens), 2) cognitive growth (Understanding CPR rationally, Increasing concern for personal and family health, Mastering self-relaxation methods), and 3) the desire for continued development (Seeking professional development, Hoping for professional psychological assistance, Strengthening team support).CONCLUSIONS:The experience of performing cardiopulmonary resuscitation by healthcare professionals in emergency departments is dynamic, with changes in mood and cognitive growth. Managers in hospitals should pay attention to their experiences and need at different stages of career development and actively carry out targeted cognitive guidance, skills training, and psychological support to help them achieve professional development and physical and mental health. At the same time, to promote the development of CPR for all, it is recommended that the authorities actively improve the public infrastructure for first aid and related policy protection.

Background: ERAS has been shown to promote perioperative recovery. However, the application of EARS in ERCP has rarely been reported in our country and abroad. This study was to investigate the effect of accelerated rehabilitation surgery on perioperative vital signs in elderly patients with choledocholithiasis treated with ERCP.

目的 系统评价非专业旁观者对院外心脏骤停者实施心肺复苏术(cardiopulmonary resuscitation,CPR)的体验.方法 检索PubMed、The Cochrane Library、Web of Science、Embase、CNKI、万方数据库、维普数据库和中国生物医学文献数据库中关于非专业旁观者实施院外CPR的心理体验及应对措施的质性研究,检索时限为建库至2022年6月.采用澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)质性研究质量评价标准评价文献质量,采用汇集性整合方法整合研究结果,采用ConQual证据分级方法评价整合结果质量.结果 初检文献1 511篇,经去重、筛选和质量评价后,最终纳入7篇文献,包括5篇现象学研究和2篇扎根理论.提炼出54个研究结果,将相似结果归纳为9个新类别,得出3个整合结果:非专业旁观者实施CPR的有利动因、非专业旁观者实施CPR时的挑战和非专业旁观者实施CPR后的应激状态和心理成长.结论 应开展符合现实需求的CPR培训以提高非专业旁观者再次施救的意愿和能力,同时关注非专业旁观者的心理和信息需求.

Objective To conduct a scoping review of domestic and foreign triage competency tools for pre-screening triage nurses.Methods The databases of PubMed, Embase, CINAHL,Cochrane Library, Web of Science, CNKI,Wanfang, and SinoMed were searched for the studies on triage competency tools for pre-screening triage nurses.The retrieval time frame was from inception to October, 2022.Relevant studies were reviewed according to the framework of scoping review.Literature data were screened and extracted by two investigators independently.Results A total of 2766 relevant articles were retrieved and 11 articles were involved.Ten triage competency tools for pre-screening triage nurses were summarized, containing the indicators of knowledge, skills, communication, teamwork, etc.Conclusions The triage competency tools for pre-screening triage nurses in China were developed in recent years.The outcome indicators of some tools need to be clarified, and their application effects need further validation.Relevant tools should be verified and refined in the future, so as to provide references for assessing and evaluating the triage competency of pre-screening triage nurses, and to facilitate the continuous promotion of pre-screening triage nursing training.

目的:采用循证研究方法评价视频健康教育对围术期患者的影响.方法:检索PubMed等数据库中有关视频健康教育的随机对照试验(RCT),检索时限为建库至2021年9月,采用RevMan5.3进行Meta分析.结果:本研究共纳入9篇RCT文献,共计2123名患者.Meta分析结果显示,视频健康教育能降低围术期患者的焦虑程度[SMD=-0.82,95％CI(-1.40,-0.25),P<0.01],提高患者满意度[OR=4.44,95％CI为(2.50,7.89),P<0.01],减少护士健康教育的时间[SMD=-2.06,95％CI(-3.98,-0.14),P=0.04],但对住院时间的影响不大[SMD=-0.42,95％CI为(-1.22,0.38),P=0.300].结论:视频健康教育能降低患者的焦虑程度、提高患者满意度、减少护士健康教育时间,但对住院时间的影响不大,有一定的临床推广意义.